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“Aging is not lost youth but a new stage of opportunity and strength.”
—Betty Friedan (1921-2006), American writer and activist
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LEARNING OUTCOMES
By the end of this chapter, readers will be able to:
11-1. Differentiate between typical and atypical age-related changes in the musculoskeletal system.
11-2. Describe the signs, symptoms, and risk factors of age-related musculoskeletal health conditions that commonly affect older adults.
11-3. Discuss the relationship between age-related musculoskeletal changes and their impact on occupational performance in older adults.
11-4. Explain occupational therapy assessment considerations for the older adult and the procedures for assessing musculoskeletal system factors, including joint ROM and muscle strength.
11-5. Select and justify use of specific assessments for the musculoskeletal system.
11-6. Identify occupational therapy interventions to address the impact of age-related musculoskeletal changes on occupational performance in older adults.
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Mini Case Study
Ms. Ford is a 72-year-old African American woman who lives with her dog, a golden retriever named Sammy. Ms. Ford and Sammy live in a two-story townhouse home. There are four steps that lead into the house with a railing on one side of the steps. There are 15 steps (no railing) from the main floor to the second floor, where Ms. Ford’s bedroom and bathroom are located. Ms. Ford’s medical history includes osteoarthritis (OA), hypertension, diabetes mellitus (DM), hyperlipidemia, and asthma. Her medications include amlodipine 5 mg daily, metformin 500 mg twice daily, glyburide 10 mg daily, simvastatin 10 mg daily, albuterol 2 puffs as needed, and acetaminophen 325 mg daily for the past 3 months for pain.
Ms. Ford was diagnosed with OA 10 years ago. She has severe pain in her hands that causes problems during dressing, primarily with the fine motor coordination needed for buttons and zippers. In addition, food preparation is difficult (e.g., cutting food and opening containers). Ms. Ford has identified pain in her right hip that has progressively worsened to the point where she has difficulty negotiating stairs and can no longer take long walks with Sammy. Prior to her diagnosis of OA, Ms. Ford was a very active woman. She volunteered at a local animal shelter twice weekly; however, she is now only able to volunteer once every other week due to hip pain. Ms. Ford loves to garden but, because of the pain in her hip and hands, she minimizes the work by maintaining only the flower boxes in the front of her house.
Provocative Questions
What are some changes in the musculoskeletal system that may be affecting Ms. Ford’s occupational performance?
How have Ms. Ford’s meaningful occupations been affected by age-related changes and health conditions affecting the musculoskeletal system?
On the basis of the information provided about Ms. Ford, what should be the main areas of focus for occupational therapy intervention? What additional information or assessments might be useful to inform the occupational therapist’s clinical judgment?
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Various tissues comprise the musculoskeletal system, ...